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AB0776 Improving Adherence To Osteoporosis Treatment by Promoting Patient Involvement in Physician/pharmacists Cooperation
  1. D. Poivret1,
  2. C. Wilcke2,
  3. V. Noirez3,
  4. C. Goetz3
  1. 1Unité ETP, Chr Metz Thionville
  2. 2URPS pharmacist
  3. 3Chr Metz Thionville, Metz, France

Abstract

Background The management of osteoporosis requires multi-years drug treatment and lifestyle changes: maintenance of adapted physical activity, adequate dietary calcium intake, maintaining balance on the ground. It is admitted that adherence to medication does not exceed 50% at one year

Objectives To improve patients follow-up, we have created cooperation between their family doctor and the City pharmacist initiated by the patient himself.

Methods We proposed participation to therapeutic session education to each osteoporotic patient at the end of which we give him a logbook that contains 6 doctor questionnaires and 6 pharmacist questionnaires. The patient remains the owner of the diary, he transmit it to his doctors and his pharmacist twice a year over 3 years. The doctor questionnaire covers the changes in lifestyle; the pharmacist questionnaire covers the medication. Once a year, doctors and pharmacists meet to develop the protocol and addressing diagnostic and therapeutic innovations. The inclusions began in January 2013. We have been able to study the results of the questionnaires one (2014) and two (2015). A nurse and a secretaress call many time ech patient to remain them the project. We conducted a semi led interview with 10 doctors and 10 pharmacists to detect the brakes and levers of successful interprofessional cooperation.

Results Cooperation physicians/pharmacists: the patient initiates cooperation doctors/pharmacists by providing logbook at regular intervals to both health professionals. Patients play a role in the initiation and continuation of their collaboration. We undertook an exploration work with the anthropological laboratory to investigate the change in the perception of its role by the patient over program. We included 48 patients in 2013. 36/48 continue their treatment at 2 years. Only 1 patient has stopped his treatment without medical reason.

4 patients discontinued treatment for dental care side, 2 for intolerance to any treatment. 9 continue their treatment althougt their physician or pharmacist don't full the questionnaire. 5 don't give any news about them.

The analysis of 73 questionnaires received at one year and 32 questionnaires received at 2 years shows sufficient dietary calcium intake at 2 years to 81% against 84% at one year and a satisfactory for ground balance 75% against 90% at one year. All patients knew at one year the name of their treatment and 96% meet the conditions of the drug taken. 69% do not forget their treatment at two years against 86% at one year thank pharmacist intervention. Only 6% wanted to stop the treatment at 2 years because of side effects, of excessive stresses, lack of noticeable effect, against 17% at 1 year, but they have not stopped after consulting the doctor and/or pharmacist. 25% improved their level of physical activity at 2 years against 14% at one year, 69% were held against 76% at one year.

Conclusions 75% patients continue their treatment at 2 years: the cooperation between doctor and pharmacist induced by the patient has a positive effect on adherence.

Disclosure of Interest None declared

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